A/R BEST PRACTICES

One of the biggest concerns in a practice is their collections.  Getting patients in the door is only half the battle.  Having their claims processed to completion is the natural outcome, but at times this seems to be the portion that gets swept under the rug.

 

Day-to-day operations gets in the way of a robust collection protocol.  In-house billers are especially challenged when they are needed to cover reception, room patients, and enter that day’s claims; all of which serve to present obstacles to being able to just sit down and work your aging accounts.  Billing companies that do not have a dedicated schedule for working the A/R can also get caught up in daily duties, and after weeks of “tomorrows”, the aging can become much more of a mountain than a molehill.

 

We have a 0.00 to 0.00 motto.  All accounts start with a 0.00 balance and our goal is to work all accounts back to a 0.00 balance. This requires some diligence and an effective accounts receivable protocol.  All accounts are worked every 30 days. There is no balance too large or small to be missed in this 30 day window.

 

Most insurance companies have a “timely” window, which applies to claim filing, but also applies to: record submission, claim corrections, claim reopening, and appeals.  If you do not work your accounts on a 30 day schedule you may miss this timely window and lose out on a claim’s reimbursement. Schedule an administrative day with your billing team for aging.  If your practice is large, schedule a couple of these each month. This day allows your biller(s) to work collections without interruption, getting all accounts addressed in the same time frame.

 

Patient accounts should also be reviewed every 30 days, ideally when statements are generated.  This can be a rolling 30, done each week, or done monthly, depending on your software’s capabilities.  When auditing patient aging, some standard rules should be set into place for the practice.  One example is: When the account has aged to 60 days with no payments, a call is made to the patient to confirm that the statement has been received.  At 90 days another call is made advising the patient that the account is now delinquent and a payment arrangement needs to be put into place.  At 120 days the account receives a pre-collection status, a letter is mailed to the patient, and if this still does not generate a payment agreement, then the account will be sent to a collection agency.  Avoid the folly of letting these sit without action.  Collection agencies need to see activity on an account in order to better apply pressure when attempting to collect a debt.  Remember, if the patient ever had intention to pay they would have responded previously.  Moving forward with a collection plan is the only recourse at times.

 

The final step in any good A/R plan is knowing when to give up.  This is obviously a last resort but there are times when it is better to expend energy elsewhere.  An example is when a procedure is performed outside of authorization time limits.  Though an appeal can and should be sent, most payers do not turn these over, and leaving them on the books indefinitely is bad business practice.  If you have tried everything possible, you cannot win, and the responsibility is ultimately yours, then write it off and move on.  Paying for time and labor on a “dead” claim is inefficient, especially when those resources can be utilized on collectable visits.

 

In the end, all lines created in a billing practice should be worked consistently and efficiently until the claim is completely resolved and a 0.00 balance is the end result.

 

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